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At least 19 recordsLinked to original sources
PubMedDate not supplied

Self-help group meeting attendance among clients with dual diagnoses.

This study explores factors associated with self-help group meeting attendance in the aftercare of 81 clients with dual diagnoses of severe mental illness and chemical dependency following their discharge from an inpatient chemical dependency treatment program. It also explores the association between self-help group meeting attendance and treatment outcomes. Data were collected from patient records and results of the Addiction Severity Index (ASI) administered as part of an earlier experiment that evaluated the effectiveness of the treatment program. Collaterals also provided follow-up information. Of thirteen variables examined, only two were associated with increased self-help group meeting attendance: having more years of education and having a major substance problem that did not include alcohol. No association was found between self-help group meeting attendance and treatment outcome regarding psychiatric problem severity or five other domains of the ASI. A moderate association was found indicating that more self-help group meeting attendance was related to improvements in the legal problems domain of the ASI. Implications are discussed for future research and for improving self-help group meeting attendance and its influence on treatment outcomes for individuals with dual diagnoses.

Adolescent↗
PubMedDate not supplied

Personality and alcohol/substance-use disorder patient relapse and attendance at self-help group meetings.

This study evaluated the role of personality in the short-term outcome of alcohol/substance-use disorder patients. Detoxifying alcohol/substance-use disorder patients were administered the Myers-Briggs Type Indicator (MBTI), the Tridimensional Personality Questionnaire (TPQ), the Michigan Alcohol Screening Test (MAST), the CAGE Questionnaire, and the Beck Depression Inventory (BDI). These patients were subsequently evaluated over a 1-month period for relapse and attendance at self-help group meetings. High TPQ Persistence scale scores predicted abstinence. When the Thinking and Feeling groups were considered separately, and when these two groups were combined into a single group, high scores for the individual groups and the combined group (i.e. Thinking and Feeling types together) predicted abstinence. High TPQ Persistence scale scores and low Shyness with Strangers and Fear of Uncertainty subscale scores predicted attendance at self-help group meetings. High MBTI Extroversion and high MBTI Thinking scores also predicted attendance at self-help group meetings. When the Extroverted and Introverted types and the Thinking and Feeling types respectively were combined, as with abstinence, high scores predicted attendance at self-help group meetings. Age, gender, CAGE, MAST, and BDI scores did not predict outcome. The above information suggests that specific personality variables may predict abstinence and attendance at self-help group meetings in recently detoxified alcoholics, and this may have prognostic and therapeutic significance.

Adult↗
PubMedDate not supplied

Neuroprotection as initial therapy in acute stroke. Third Report of an Ad Hoc Consensus Group Meeting. The European Ad Hoc Consensus Group.

Although a considerable body of scientific data is now available on neuroprotection in acute ischaemic stroke, this field is not yet established in clinical practice. At its third meeting, the European Ad Hoc Consensus Group considered the potential for neuroprotection in acute stroke and the practical problems attendant on the existence of a very limited therapeutic window before irreversible brain damage occurs, and came to the following conclusions. NEUROPROTECTANTS IN CLINICAL DEVELOPMENT: Convincing clinical evidence for an efficacious neuroprotective treatment in acute stroke is still required. Caution should be exercised in interpreting and extrapolating experimental results to stroke patients, who are a very heterogeneous group. The limitations of the time windows and the outcome measures chosen in trials of acute stroke therapy have an important influence on the results. The overall distribution of functional outcomes provides more statistical information than the proportion above a threshold outcome value. Neurological outcome should also be assessed. Neuroprotectants should not be tested clinically in phase II or phase III trials in a time window that exceeds those determined in experimental studies. The harmful effects of a drug in humans may override its neuroprotective potential determined in animals. Agents that act at several different levels in the ischaemic cascade may be more effective than those with a single mechanism of action. CURRENT IN-HOSPITAL MANAGEMENT OF ACUTE STROKE: The four major physiological variables that must be monitored and managed are blood pressure, arterial blood gas levels, body temperature, and glycaemia. The effects of controlling these physiological variables have not been studied in prospective trials, though they may all contribute to the outcome of acute ischaemic stroke and affect the duration of the therapeutic window. Optimal physiological parameters are inherently neuroprotective. Trials of new agents for the treatment of acute stroke should aim to maintain these physiological variables as close to normal as possible, and certainly within strictly defined limits. THE PLACE OF NEUROPROTECTANTS IN ACUTE STROKE MANAGEMENT: Stroke patients are a very heterogeneous group with respect to stroke mechanisms and severity, general condition, age and co-morbidities. At the present time, the only firm guideline than can be proposed for patient selection is the need for early admission to enable neuroprotectant and/or thrombolytic treatment to be started as soon as possible within the therapeutic window. The severity of potential side-effects will largely determine who should assess a patient with suspected stroke and initiate treatment. There is little information on which to base the duration of neuroprotectant therapy, and more experimental data are needed. Even if prehospital treatment proves to be feasible, it should not replace comprehensive stroke management in a specialist hospital unit. Clinical trials of neuroprotectants should only be performed in stroke units. The combined approach of restoring blood flow and providing neuroprotection may be the most productive in human stroke, but current clinical trial design will have to change in order to test combination therapy. Important side-effects are those that interfere with any possible benefit or increase mortality. PHARMACO-ECONOMIC ASPECTS OF NEUROPROTECTANTS: The early increase in hospital cost associated with neuroprotectant therapy may be balanced by the shorter length of hospital stay and lesser degree of disability of the surviving patients. The overall direct financial cost is highly dependent on the number of patients eligible for neuroprotectant therapy, which is itself dependent on the length of the therapeutic window and the severity of potential side-effects. A treatment that achieves a good functional outcome is the most cost-effective approach.

Acute Disease↗
PubMed2005

Do systematic multiprofessional rehabilitation group meetings improve efficiency in vocational rehabilitation?

PURPOSE: The aim of the present study was to investigate differences in the effects on employment between clients whose rehabilitation was coordinated in systematic multiprofessional rehabilitation group meetings and clients whose rehabilitation was coordinated in the "conventional" way. METHOD: The study was based on a sample of 51 individuals who received systematic group meeting coordination. All individuals in the study group were unemployed before the rehabilitation intervention. Two different comparison groups were chosen: one at a local level and another at a national level. The groups were matched on an individual level based on records obtained from The National Labour Market Board (AMS) and The National Social Insurance Board (RFV). The data were analysed by an analysis of variance (ANOVA) for repeated measures for binary responses. RESULTS: 68.6% in the study group and 49% in both the local comparison group and national group had some form of employment 24 months after rehabilitation. The ANOVA analyses (in terms of odds ratio) found that when all measurement points (6, 12 and 24 months after the rehabilitation) were included in the calculations that there was twice as high a chance of becoming employed after having received rehabilitation services through the multiprofessional group than for both comparison groups. The majority of employment in all the groups was associated with some form of subsidy or sheltered employment.

Adolescent↗
PubMed1989

Types of large-group meetings in the therapeutic community: with special emphasis on the long-term unit.

LARGE-GROUP meetings in which all of the patients and staff of a unit or small hospital gather together have been an invariable component of therapeutic communities since the time of Maxwell Jones (1953). Equally invariable is the finding in the large-group event in group relations conferences that work is extremely difficult to accomplish in the large group (Turquet 1975). Considering how much the large group is used in therapeutic communities, how many claims are made for its usefulness, and how many human resources are employed, only a modest amount of literature now exists on the large group in the therapeutic community. There is a paucity of systematic research on the topic (Trauer 1987), and except for a kind of ritualized staff wrap-up following the meeting, there is virtually no formal teaching about the meaning, goals or leadership of such meetings. In the literature to date are several overlapping proposals for typologies of community meetings according to the nature of the patient population, the nature of the tasks assigned to the meeting, and the optimal degree of structure for the meeting. The task of this contribution is twofold: first, to suggest a tripartite differentiation in the types of large-group meetings, which takes into account the authors' experience as well as previous literature; second, to suggest that these are pure types and that most settings require a mixture of two or three types. In particular we are interested in those meetings most appropriate to the long-term unit. It is our hope that a clarification of types will facilitate a more systematic approach to clinical, administrative and educational dilemmas.

Group Processes↗
PubMed1986

Restructuring group meetings for effectiveness.

As hospital systems become more complex, health administrators spend more of their time facilitating group decision making. To have effective group management and active participation, group members must value a meeting, and the group should be able to address a large number of issues in an efficient manner. In one rapidly expanding health care system, a group meeting was evaluated in relation to the format and the value to group members. The meeting was then reorganized for optimal efficiency and an evaluation of the effect of the restructuring on the group's perception of the meeting was done.

Colorado↗
PubMed1982

Group meetings on an adolescent medical ward.

This report describes the development, functioning, content, and usefulness of patient group meetings on an adolescent medical ward. The meetings prove to be a useful technique in furthering the objectives of psychiatric consultation in such a setting. The meetings convinced the author that the threat to developing autonomy is the major focus of emotional conflict for the hospitalized adolescent. The meetings prove beneficial in helping the patients adjust to the experience of hospitalization. A diagnostic and educational function is also served.

Adolescent↗
PubMedDate not supplied

Nursing diagnoses identified during parent group meetings in a neonatal intensive care unit.

PURPOSE: To identify nursing diagnoses in the reports of parents obtained during parent support group meetings in a neonatal intensive care unit. METHODS: An explorative descriptive study using records obtained during 29 meetings over a period of 11 months with parents and family members. FINDINGS: Six NANDA-approved nursing diagnoses were identified from parent group data: fear, risk for impaired parent/infant attachment, parental role conflict, risk for ineffective breastfeeding, impaired home maintenance, and risk for caregiver role strain. Diagnoses were not validated with parents. DISCUSSION: Support groups helped the parents express their thoughts and feelings and provided nurses with opportunities to identify nursing diagnoses and interventions. The identification of nursing diagnoses showed that nursing interventions that are focused on improved parent outcomes should be implemented for parents and other family members. IMPLICATIONS: Nursing care in neonatal units should focus on interventions for parents and other family members in addition to providing the necessary care of newborns.

Adaptation, Psychological↗
PubMed1987

Work site group meetings and the effectiveness of a televised smoking cessation intervention.

At the work site, smoking accounts for increased health care expenses and worker absenteeism due to smoking-related illness and reduced productivity and lost wages. Developing comprehensive and accessible smoking cessation programs at the work site is an important objective for health care professionals. In this study, employees of 43 corporations participated in a televised smoking cessation program accompanied by self-help manuals. The media component involved presenting a smoking cessation program on a network television affiliate station during the 4:30 p.m. and 10:00 p.m. news for 20 days. Employees at half the corporations also had access to semiweekly self-help group meetings. Adding self-help support groups to a program involving self-help manuals and the media reports was found to significantly increase abstinence and its maintenance over time. The implications of using the media, self-help groups, and work site locations in large-scale community-based interventions are discussed.

Adult↗
PubMedDate not supplied

A weekly group meeting for children on a pediatric ward: therapeutic and practical functions.

The multiple sources of psychological stress to the hospitalized child are reviewed with references to the literature. The Hahnemann Pediatric Ward and patient population are described as are the functions of a weekly group meeting for school aged hospitalized children led by a child psychiatrist. Efforts are made to use knowledge gained from the children for therapeutic purposes within the group as well as for teaching the inpatient pediatric staff how the hospitalized child's behavior reflects his inner thoughts and feelings. Aspects of the children's behavior and verbal productions in the group are discussed from a psychodynamic viewpoint. Conflict, ambivalence, fantasy distortion, denial and displacement are exemplified, as is the children's ever-present need to simultaneously express, defend against and master anxiety. Questions are raised about outcome and future avenues of investigation.

Attitude to Health↗
PubMedDate not supplied

[Group meetings for patient recruitment in clinical trial in pediatrics].

Recruitment of patients in a clinical trial is often difficult and probably more difficult in pediatrics where parents are asked to give the informed consent. In order to recruit infants in a randomized clinical trial we organized group meetings with families (4 to 40 at a time) in order to describe the study procedures: random allocation to treatment or placebo and double blind assessment, and ask them to allow their child to participate. All meetings were conducted by both a pediatrician and a RCT specialist. Parents asked questions about the effects of the drug, the evaluation process and the follow-up procedures. Forty nine % of all eligible infants participated in the study. The success rate was related to franc and open communication with the family, provided by highly qualified physicians.

Child↗
PubMed2001

Supplementation of urban home visitation with a series of group meetings for parents and infants: results of a "real-world" randomized, controlled trial.

OBJECTIVE: Home visitation has been shown to be effective in reducing rates of child maltreatment and in enhancing psychosocial outcomes in children and their parents. Even when available, however, it is underutilized by parents in some urban settings. We tested a supplemental 10-session group intervention for its ability to increase active participation in home visitation, enhance the quality of caregiving behavior of parents, and improve social developmental outcome in children. METHOD: A randomized controlled design was utilized, involving two separate cohorts of parents of 3- to 18-month old infants, totaling 148 parent-child dyads. The intervention focused on practical experience in promoting parent-infant attachment relationships. RESULTS: At 6 months follow-up, there was a substantial increase in the proportion of intervention group parents participating in home visitation, compared to parents in the control group (Fisher's exact p = .008). Parents in the intervention group exhibited a trend for improvement in their capacity to appropriately interpret infants' emotional cues (p = .08), independent of the effects of home visitation itself. Attrition in both the treatment and control groups was inversely associated with income and level of education. CONCLUSIONS: Group meetings may constitute an effective means of engaging stressed urban families in home visitation.

Adult↗